What Is Male-Pattern Hair Loss?

Most men will experience male-pattern hair loss (MPHL) from their mid-twenties onwards. It is usually a gradual process and typically occurs in a symmetrical way, affecting the frontal scalp at the sides (bitemporal area) and the crown. Some men experience a more general thinning of the front of the scalp.

Like FPHL it also known as androgenetic alopecia. Some men will develop this much earlier than others, which can be very distressing. Once again there is no cure for MPHL, but with treatment, preferably as early as possible, hair can regrow and hair loss stabilise.

A dermatologist will be able to undertake investigations to exclude other causes of hair loss, including blood tests and sometimes a biopsy.

Treatments include the following:

Topical minoxidil 5% often works well, but needs to be continued and used regularly, preferably nightly. It is available as lotions or foams which are massaged into the scalp before bed. Reversible hair shedding may occur at the start of treatment. If minoxidil is effective hair should thicken within 4-12 months.

Finasteride tablets are anti-hormonal treatments licensed for treatment of MPHL in the UK, but are not available on NHS prescription. They are taken daily and can be used in combination with topical minoxidil or by themselves. They should be taken under supervision. A dermatologist will be able to discuss possible side effects with you before you start. Dutasteride is a similar treatment that may be recommended.

Other treatments including laser therapy, platelet-rich plasma injections and biotin are sometimes used, although evidence for benefit is limited and long-term effects are unknown.

Hair transplantation techniques have advanced substantially in the last 20 years, so that now individual follicular units are taken from areas of higher hair density, usually the back of the scalp, and inserted under local anaesthetic into the thinner areas.

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